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Original Investigation
AAFPRS Facial Rejuvenation Featured Article
July 11, 2019

Evaluation of Personality Perception in Men Before and After Facial Cosmetic Surgery

Author Affiliations
  • 1Georgetown University School of Medicine, Washington, DC
  • 2Brooke Army Medical Center, Fort Sam Houston, Texas
JAMA Facial Plast Surg. 2019;21(5):369-374. doi:10.1001/jamafacial.2019.0463
Key Points

Question  Is facial cosmetic surgery in men associated with the perception of attractiveness, masculinity, and personality?

Findings  This survey study of 145 lay participants who rated photographs of 24 men before and after facial cosmetic surgery demonstrated significant postoperative improvements in perceptions of attractiveness, likeability, social skills, and trustworthiness.

Meaning  These results may broaden the understanding of cosmetic surgery’s association with societal perceptions of persona.


Importance  Facial cosmetic surgery has previously focused on improvements in perceived physical attractiveness and youthfulness. However, human beings are judged throughout life based on many other characteristics and personal qualities that are conveyed by their faces.

Objective  To examine the association of facial cosmetic surgery in men with perceptions of attractiveness, masculinity, and personality traits.

Design, Setting, and Participants  Cohort study with retrospective evaluation by blinded raters of preoperative and postoperative photographs of 24 male patients who underwent facial cosmetic surgery between January 1, 2009, and January 31, 2016. A total of 6 surveys were constructed with 8 sets of photographs each (4 preoperative and 4 postoperative). Each of these surveys was then sent to at least 36 lay people via the web-based survey tool Survey Monkey. Additional invites were sent for individual surveys until a minimum of 24 responses were received for each survey. Preoperative and postoperative photographs of the same patient were not placed in the same survey to avoid recall bias. Anonymous raters used a 7-point Likert scale to rate their perception of each patient’s personality traits (aggressiveness, extroversion, likeability, risk seeking, sociability, and trustworthiness), attractiveness, and masculinity based on photographs in their assigned survey. Raters were blinded to study intent. Data analysis was performed between August 2018 and March 2019.

Main Outcomes and Measures  Ratings of personality, attractiveness, and masculinity.

Results  This survey study included photographs of 24 men who underwent facial cosmetic surgery; the mean (SD) age of the patients was 49.3 (16.4) years. A total of 145 participants completed the survey; the majority of respondents were men (n = 81; 56%) between the ages of 25 and 34 years (n = 116; 80%). Score increases were significant for perceived attractiveness (0.29; 95% CI, 0.13-0.46), likeability (0.41; 95% CI, 0.24-0.57), social skills (0.25; 95% CI, 0.08-0.40), and trustworthiness (0.27, 95% CI, 0.11-0.44) when evaluating all facial cosmetic procedures together (upper blepharoplasty, lower blepharoplasty, face-lift, brow-lift, neck-lift, rhinoplasty, and/or chin implant). Upper blepharoplasty was associated with positive changes in perceived likeability (0.72; 95% CI, 0.06-1.50) and trustworthiness (0.74; 95% CI, 0.22-1.25). Lower blepharoplasty was associated with decreased perception of risk seeking (−0.78; 95% CI, −1.45 to −0.10). Face-lift was associated with increased perception of likeability (0.69; 95% CI, 0.08-1.30) and trustworthiness (0.66; 95% CI, 0.05-1.27). Neck-lift was associated with increased perception of extroversion (0.60; 95% CI, 0.10-1.09) and masculinity (0.70; 95% CI, 0.21-1.19). Patients who underwent rhinoplasty had improvements in perceived attractiveness (0.51; 95% CI, 0.03-1.00) and likeability (0.40; 95% CI, 0.03-1.00). Chin augmentation did not show any significant improvements.

Conclusions and Relevance  The results of this study suggest that men undergoing facial cosmetic surgery may experience changes in perceived attractiveness, masculinity, and a variety of personality traits. These findings complement those from a previous study on female patients, which together broaden the understanding of the association of cosmetic surgery with societal perceptions of persona.

Level of Evidence  NA.